Lenvatinib plus TACE versus Sorafenib plus TACE for advanced hepatocellular carcinoma: A systematic review and meta-analysis

Abstract

Abstract Objective The goal of this systematic review was to compare the effectiveness and safety of the treatment of advanced hepatocellular carcinoma (HCC) with lenvatinib plus transarterial chemoembolization (TACE) versus sorafenib plus TACE. Method A comprehensive search was conducted across multiple databases, including PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wangfangdate, and CBM. We computed pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) to assess overall survival (OS), progression-free survival (PFS), and time to progression (TTP). Additionally, we determined pooled risk ratios (RRs) and their 95% CIs to evaluate the objective response rate (ORR), disease control rate (DCR), and adverse events (AEs). Result The analysis comprised a total of 7 studies with 682 patients as the sample size. The results of our study indicate that the combination of lenvatinib and TACE demonstrated significantly improved OS (HR = 0.594, 95% CI: 0.484–0.730, p < 0.001), PFS (HR = 0.417, 95% CI: 0.302–0.574, p < 0.001), TTP (HR = 0.603, 95% CI: 0.442–0.824, p = 0.001), ORR (RR = 1.820, 95% CI: 1.272–2.605, p = 0.001), and DCR (RR = 1.333, 95% CI: 1.040–1.708, p = 0.023) compared to the combination of sorafenib and TACE in patients with advanced HCC. Additionally, there was no significant difference found in the overall adverse events of all-grade (RR = 1.054, 95% CI: 0.984–1.128, p = 0.136) and grade 3/4 (RR = 1.062, 95% CI: 0.875–1.289, p = 0.542) between the two groups. Conclusion Lenvatinib plus TACE improved OS, PFS, TTP, ORR, and DCR compared with sorafenib plus TACE in advanced HCC with an acceptable safety profile.